Checking for implantation issues

August 2nd, 2009

From my research into finding our more about my fertility challenges, I have investigated and continue to investigate implantation issues. Given how beautiful my Basal Body Temperature (BBT) charts have been over the years and the fact that  I seem to ovulate successfully every cycle, I have always suspected that there might be issues with either the sperm getting to the egg or the fertilised egg implanting properly in my uterus. I have no proof on which to base this supposition – call it woman’s intuition or just plain ole guessing.

However, I have discovered that in Assisted Reproductoin (ART) about 90% of fertilised eggs do NOT implant successfully! That is terrible odds. It also suggests that implantation dysfunction might be a challenge for many women.

Implantation has to do with the quality of the uterine lining as every woman who has had IUI or IVF knows from the ultrasound to look at the thickness and striation of the lining. Most docs look for a lining of over 9, in whatever units they use to measure these things.  There is also such a thing as a lining that is too thick.  So there is some perfect range for the thickness of the lining. But even if you fall within this range, that is no guarantee of success, as I fully well know from my perfect IUI in which the doc said my lining was one of the most beautiful she had ever seen in thickness and striation and whatever else.

The other critical factor that might affect implantation issues is the level of endometrial receptivity. The endometrium is the uterine lining, and it needs to be receptive to allowing the fertilised egg to implant. The endometrium secretes several different substances that assist in implantation. One of these is a substance known as MAG. The uterine lining secretes higher levels of MAG from days 5 through 18 and ceases secretion on day 19 in woman with normal fertility.

Studies have shown that women with unexplained infertility have abnormal levels of MAG secretion and may continue to secrete it after day 19. Some women secrete no MAG at all and these women never get pregnant even with donor eggs! Women with abnormal MAG levels get pregnant with donor eggs at a much reduced level than women with normal MAG levels.

So maybe that might be my issue – a problem with the uterine lining in which it does not secrete the right levels of MAG. Is there anything that can be done to fix this problem so that we can have our baby? I will be investigating that.

Knowing your egg fertilised hours after it happened!!

August 2nd, 2009

There is an advertisement for a popular early home pregnancy test that talks about how wonderrful it would be to know that you are pregnant hours after you conceived.  And to the many women struggling with infertility and desperate to have a baby, it certainly would be wonderful.

Pregnancy refers to the successful implantation of a fertilised egg. Implantation usually takes anywhere from 6-12 days after ovulation to occur. Once implantation of the embryo into the uterus occurs successfully then the body starts to produce the pregnancy hormone, HCG. This is the hormone that home pregnancy tests measure and some claim to have a sensistive that measures as low as 20 units of HCG.

But sometimes the egg might get fertilised by the sperm but not implant successfully. Is there any way to figure out if your egg was successfully fertilised? Apparently there is. There is a substance known as Early Pregnancy Factor, EPF, which the body produces once a success fertilisation has taken place. The fertilised egg does not produce it directly but stimulates the body to produce it. And it can be tested for.

So in fact, you CAN know if your egg was successfully fertilised anywhere as early as 6 hours after fertilisation has occurred! The range given is between 6-48 hours. Isnt that amazing? I am not sure how available this test is. But it has been around since 1976 so it cant possibly be so state of the art that only specialised labs have it. Or can it? But the point is that we can know if we have gotten one step closer to having our baby.

We can test for EPF and thus know if the sperm fertilised the egg. If we still do not get pregnant then we will know that it is definitely some kind of implantation issue. In another article I will talk about testing the uterine lining to determine receptivity levels for the embryo.

The things we find out on our journey to becoming a mommy!